Health Care In Spain Research Articles

An organizational model for a primary care program of home health care in Spain: a description of the program.

The National Institute of Health (INSALUD) in Spain has successfully used a model of home care that has two major components, each using the physician as part of the team that provides care at home. The first component is home health care that is provided to chronically ill, terminally ill and homebound patients, whereby professionals of primary care provide care for the patient at home, along with other professionals who provide specialized care as support elements. The second component is hospitalization at home, whereby care is provided to acutely ill patients or patients with a precocious medical or surgical discharge from the hospital. The professionals from the hospital provide the basis of care. and the primary health care professionals are the support elements. Both components incorporate a team of support.

Petrol tax to fund healthcare in Spain

Petrol tax to fund healthcare in Spain

Regional Inequality in the Provision of Health Care in Spain

Whereas studies on regional inequality tend to focus on income disparities, we investigate regional inequality in Spain with respect to health facilities. In this study we examine trends in regional inequality over the period 1964 to 1991 during which fundamental changes in health policies were implemented. We follow a multidimensional approach in the sense that several indicators of health facilities are considered. Regional inequality is measured by means of Theil's second measure of multidimensional inequality. The partial common principal components (PCPC) model is used to construct the weights for this measure whenever appropriate, and principal component analysis (PCA) is used when otherwise. The PCPC model is a generalisation of the classical method of PCA for several samples (years). Component coefficients are estimated by assuming that the first component is common for all years. Spatial inequality between regions as well as within regions is analysed to highlight the role of policy and other regional characteristics. Spatial spillovers are analysed by including the effects of health facilities in neighbouring regions. The analysis shows that the health policies of the Spanish government in the 1980s and decentralisation of power may have helped to reduce regional inequality, although no firm conclusions can be drawn yet.

Las hospitalizaciones por ambulatory care sensitive conditions: selección del listado de códigos de diagnóstico válidos para España

BackgroundHospitalisations due to Ambulatory Care Sensitive Conditions (ACSC) are considered an indicator to measure the use of hospital services because of health conditions that could have been prevented and controlled by primary health care. The objective of this study is to select the list of diagnostic codes to assess the performance of primary health care in Spain. MethodsThe five criteria proposed by Weissman and Solberg, to select an appropriate indicator, were applied to a first list of 87 ACSC diagnostic codes identified through bibliographic search. Information on two main criteria –whether care for a health condition was a primary health care role and whether hospitalisation was needed once the health problem occurred– was obtained by means of the Delphi technique. A group of 44 experts gathered together for the study. For the remaining criteria, information came from the results of the «Pilot study on hospitalisations due to ACSC in Catalonia, Spain». Meeting the five criteria was the criterion selected to evaluate the solving ability of primary health care. Resultsa) from the Delphi group: 42 (95.4%) participants completed the three rounds. The question on whether the care of the selected health conditions was responsibility of primary health care reached a high level of consensus (between 86.1 and 100%). The consensus on the need for hospitalisation was lower, from 75.7 to 88.6%, moreover, 5 diagnostic codes did not reach the established consensus, and b) from the ACSC selection process: five diagnostic codes did not meet the criteria and were excluded. Out of the remaining 82, all them were considered as health problems to be cared for at primary level and in 37 cases hospitalisation was considered always as necessary. Thirty-five diagnostic codes, that met the five criteria, represented the set of ACSC diagnostic codes in our setting. ConclusionsA set of 35 diagnostic codes of ACSC, adapted to our setting, is proposed to evaluate primary health care performance. The selected codes reduce significantly the limitations that stem from hospital admission criteria due to patient clinical characteristics, variations in hospital medical practice, and hospital admission policies.

Measurement of Inequity in the Delivery of Public Health Care: Evidence from Spain (1997)

This paper assesses horizontal equity in the delivery of public health care in Spain, and tries to identify those health care levels and population groups where inequality is concentrated. Different kinds of health care are analysed for 1997, both at disaggregate and aggregate level. The results show that the socio-economic population groups affected by inequity vary according to the specific health care level studied although, in global terms, there is not a clearly significant degree of inequity. The Spanish results are also compared to those obtained for other European countries.

¿Podemos mejorar la prevención de la tuberculosis? Análisis de la aplicación de la quimioprofilaxis

To analyze the situations that make chemoprophylaxis for tuberculosis difficult. One hundred twenty-eight patients consecutive (106 HIV negative and 22 HIV positive) diagnosed of tuberculosis (TB) were studied. The patients were interviewed and a questionnaire was filled out in order to identify risk groups and determine what steps had been taken to prevent TB. In the HIV negative group, 63 (57.8%) had at least one risk factor. The most common were contact with persons with active TB (31.1%), former TB (15.1%), rapid weight loss or chronic malnutrition (13.2%) and residence in closed institutions (5.6%). Of the 51 (48.1%) for whom evaluation of chemoprophylaxis was indicated, 43 (84.3%) had been examined by a physician within the past five years; only 10 (23.3%) of them, however, had been checked for TB and isoniazide had been prescribed for only 4 (9.3%). In the HIV positive group, 13 (72.2%) of those for whom evaluation of chemoprophylaxis was indicated had been seen by a physician; 12 (97.7%) of them were given tuberculin tests checked for TB and isoniazide was prescribed for 4 (30.7%). None of the patients in either group who were prescribed a full course of prophylaxis actually took the drug enough. Most HIV negative patients for whom evaluation of chemoprophylaxis was indicated had been examined by a physician in the five years before disease was detected; less than a quarter of them were checked for TB, however. This situation is probably a consequence of the structure of health care in Spain as it affects TB control. Nearly all the HIV positive patients were checked for the disease, as they benefited from protocolized health care.

Mental health care in Spain

Spain is a member state of the European Union, covering over 500,000 km2 and with a population of more than 40 million. However, taking into account only the gross national product, there is no doubt that Spain still belongs to the southern countries.

Regeneracionismo y Salud Pública: el bienio de Ángel Pulido al frente de la Dirección General de Sanidad (1901-1902)

The organization of public health services in Spain did not ignore the regenerationist movement, which became especially important after the loss of the colonies in 1898. The need to bring the country in line with the rest of Europe accentuated the conviction that health care in Spain was not up to the standards to be expected in a modern country. Against this background, Angel Pulido occupied his post in the General Directorate of Health from 1901 to 1902. His labors were characterized by three major features: the diagnosis of the precarious status of health in the country, which required urgent "regenerationist" measures comparable to those applied to other aspects of life in Spain; the importance of health education at all levels of society; and the need to combat the evils of the peculiar political game of his time, a key obstacle to the effective organization of public health services.

Influence of socioeconomic and health care development on infant and perinatal mortality in Spain 1975-86.

This study aimed to analyse the influence of social, economic, and health development on infant and perinatal mortality in Spain between 1975 and 1986, and to identify possible changes in these relationships over time. Study of the association between mortality and a range of variables. 50 Spanish provinces. Mean infant and perinatal mortality were estimated for two periods--1975-8 and 1983-6. Social, economic, and health care indicators were collected as independent variables for these two periods. The rates of variation between periods were estimated for each variable. Multiple linear regression models were used to define the association between infant and perinatal mortality and their respective rate of variation with the former indicators. Mean familial income was the main predictive factor for infant and perinatal mortality in the first period but in the second period health care indicators were more relevant. The reduction in Spanish infant and perinatal mortality over the period can be attributed mainly to the improvement in prenatal and neonatal health care in Spain in recent years, while economic factors seem less important.

The disenchantment of professionals in a new, implemented model of primary health care in Spain: A structural equations model

Abstract A new model of primary health care has been progressively implemented in Spain. Previous research (Peiró and González-Romá 1991) suggested that the implementation of this new model has produced a kind of disenchantment—that is, an experience of negative surprise—among health care professionals involved. In the present paper, a structural equations model about the antecedents and consequences of the experience of surprise is tested in a sample of 432 health care professionals working in 44 Primary Health Care Teams (PHCT). The results obtained showed that the number of uncovered functions in the PHCTs, the discrepancy between actual and desired time allocation, and the assessment of changes produced by PHCTs are relevant antecedents of the experience of surprise, while job satisfaction and propensity to leave the PHCT appear as relevant consequences.

Primary Health Care in Spain

Primary Health Care in Spain

Spanish Medicine: Trying to Heal Itself

Recently, I returned to my alma mater to teach the first American-style medical ethics course at the University of Madrid School of Medicine. Besides the teaching, I visited many hospitals trying to start up discussions about ethics and ethics committees. My work provided me with a close-up look at Spain's health care system, and I came away both impressed with its ideals and shocked by its reality. The socialization of Spanish medicine has been gradual. Franco began the first phase in 1942 when he withheld a percentage of every industrial worker's salary to provide medical care, retirement, and welfare benefits. During the 1960s, the system was expanded to include white-collar workers and even some professional groups. Long before today's socialist party came to power in 1981, the fascist government had extended health benefits to more than 80% of the Spanish population and made an enormous investment in high-tech tertiary-care hospitals.

Mental Health Care in Spain, 1960-1985

Mental Health Care in Spain, 1960-1985